Doctors Notes


Dr. Cindy Asbjornsen


What To Do About Swollen Legs


community, can be isolated to one area of the body or affect the entire body. There are many underlying causes of edema, including but not limited to pregnancy, certain medications, congestive heart failure, venous insufficiency, cirrhosis, or kidney disease. In fact, swelling is the body’s normal response to an injury or inflammation, such as a sprain, bumping into something, or even a bee sting. As healing progresses, the excess fluid leaves the area and the swelling goes down.


S Edema of the legs can cause them to feel


heavy and may even interfere with walking. If the edema is severe enough, it can interfere with blood flow. Chronic swelling also puts people at risk for cellulitis, a potentially serious bacterial infection that can cause the skin to become red, swollen and tender. Those with venous symptoms can also be at increased risk for superficial throm- bophlebitis, which are clots within the superficial veins that can be extremely painful.


Swelling due to veins One possible cause for edema in the leg


is venous insufficiency. Venous insufficiency is defined as the impairment of blood flow towards the heart. The legs are comprised of a network of veins that are similar to branches on a tree: they contain large, major veins and increasingly smaller veins. Oxygenated blood is constantly be- ing pumped from the heart to the rest of the body through the arteries. Veins then carry deoxygen- ated blood back to the heart. Healthy leg veins have valves, which open and close to assist the return of blood to the heart. Venous insufficiency, also known as vein reflux, occurs if these valves become damaged, allowing the backward flow of blood in the legs. Because gravity takes its toll on the legs more than on other parts of the body, these vein walls are under tremendous pressure. When blood cannot be properly returned through the vein, it can pool,


welling of the feet, ankles or legs is a com- mon problem that affects men and women alike. Edema, as it is known in the medical


leading to a feeling of heaviness and fatigue, and very often, swollen legs. If you have leg swelling due to venous insuffi-


ciency, wearing graduated compression stockings can help promote the flow of blood back up to the heart. They are available at many pharmacies and medical supply stores. Also, elevating your legs above your heart periodically throughout the day, especially after you have been standing for a long time, can give much relief. (See “Elevation” sidebar for more tips.) Lastly, protecting the skin over the swollen area from cuts, scrapes or extreme temperatures is very important. The skin becomes more fragile over time and any injuries can take much longer heal.


Treating the underlying cause


The treatment of leg edema depends upon a proper diagnosis. Those who experience leg swelling should visit his or her physician or specialist to determine the cause. A variety of tests will likely be given, sometimes including a venous ultrasound test to look for blockages or faulty valves in the leg veins. Effective treatment for swelling due to venous


insufficiency begins with a thorough evaluation from a qualified phlebologist (vein specialist) who will look for the source of the problem: the leaky valve or valves. Once that is identified, the physician can recommend the appropriate pro- cedure or therapy. Endovenous laser ablation, for instance, is a minimally invasive office procedure that can fix the underlying problem of venous insufficiency. Dr. Cindy Asbjornsen is the founder of the


Vein Healthcare Center in South Portland, Maine. Certified by the American Board of Venous and Lymphatic Medicine, she cares for all levels of venous disease, including spider veins, varicose veins and venous ulcers. Dr. Asbjornsen is the only vein specialist in Maine to be named a Fel- low by the American College of Phlebology. You can contact Dr. Asbjornsen at 207-221-7799 or info@veinhealthcare.com. See ad on page 6.


26 Essential Living Maine ~ January/February 2015


blood circulation and provide some relief to venous symptoms, such as achiness and swelling. In fact, I believe that elevation is so important for someone with vein disease that at the Vein Health- care Center we provide recliners and ottomans in the reception area, so that patients can elevate while they wait. By “elevation,” I mean, ide-


E


ally, raising the legs above heart level. The perfect position is to lie on a couch with your back on the cushions and feet up on the arm- rest, so feet are at a slight angle higher than the heart. Lying down with your legs resting on three or four pillows also works well. Elevation of the legs can alleviate the pain or swelling that is the result of early stage vein disease, and a vein specialist can guide patients on the most effec- tive elevation techniques. Here are several tips on how to get the most out of this acces- sible therapy: • Elevating at intervals throughout the day can encour- age blood flow out of the legs and decrease the pooling of blood. • Evening is a good time to


elevate. • Some effective times to


elevate are after a hot shower, or after standing for a long time. • A good way to remember


to elevate is to pair it with your meals or snacks. (A rest after eating can also be helpful for digestion!)


Elevation Tips for Swollen Legs


levation is a simple, yet power- ful, tool that can help improve


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